Infertility in Australia circa 1980 : an historical population perspective on the uptake of fertility treatment by Australian women born in 1946-51

Objective: To estimate the prevalence of lifetime infertility in Australian women born in 1946-51 and examine their uptake of treatment. Methods: Participants in the Australian Longitudinal Study on Women's Health born in 1946-51 (n=13,715) completed up to four mailed surveys from 1996 to 2004. The odds of infertility were estimated using logistic regression with adjustment for socio-demographic and reproductive factors. Results: Among participants, 92.1% had been pregnant. For women who had been pregnant (n=12738): 56.5% had at least one birth but no pregnancy loss (miscarriage and/or termination); 39.9% experienced both birth and loss; and 3.6% had a loss only. The lifetime prevalence of infertility was 11.0%. Among women who reported infertility (n=1511), 41.7% used treatment. Women had higher odds of infertility when they had reproductive histories of losses only (OR range 9.0-43.5) or had never been pregnant (OR=15.7, 95%CI 11.8-20.8); and higher odds for treatment: losses only (OR range 2.5-9.8); or never pregnant (1.96, 1.28-3.00). Women who delayed their first birth until aged 30+ years had higher odds of treatment (OR range 3.2-4.3). Conclusions: About one in ten women experienced infertility and almost half used some form of treatment, especially those attempting pregnancy after 1980. Older first time mothers had an increased uptake of treatment as assisted reproductive technologies (ART) developed. Implications: This study provided evidence of the early uptake of treatment prior to 1979 when the national register of invasive ART was developed and later uptake prior to 1998 when data on non-invasive ART were first collected.

Early users of fertility treatment with hormones and IVF : women who live in major cities and have private health insurance

Objective: To identify early users (women aged <34 years) of fertility treatment with hormones and in vitro fertilisation (IVF). Methods: A cross-sectional survey of infertile women from fertility clinics (n=59) and from the community (Australian Longitudinal Study on Women's Health participants) who had (n=121) or had not (n=110) used hormones/IVF as treatment for infertility. Associations between socio-demographic, reproductive and lifestyle factors, medical conditions and recurrent symptoms and using treatment (or not) were analysed using multivariable logistic regression. Results: Among infertile women who had used treatment (community vs clinic), women from clinics had lower odds of living outside major cities, using hormones only, i.e., not IVF, or recurrent headaches/migraines, severe tiredness, or stiff/painful joints; and higher odds of recent diagnoses of urinary tract infection or anxiety disorder. Compared to infertile women who had not used treatment, women from clinics had lower odds of living outside major cities, recurrent allergies or severe tiredness; and higher odds of having private health insurance for hospital or ancillary services, recent diagnosis of polycystic ovary syndrome or recurrent constipation. Conclusions: Compared to infertile women in the community, living in major cities and having private health insurance are associated with early use of treatment for infertility at specialist clinics by women aged <34 years. Implications: These results provided evidence of inequity of services for infertile women.

Infertility resolved with or without fertility treatment in Australian women aged 31-36 years: A prospective, population-based study [abstract]

Birth outcomes during a three year period were compared for women with a history of infertility who did or did not use fertility treatment with hormones and/or in vitro fertilisation. Participants in the Australian Longitudinal Study on Women’s Health born in 1973-78 were randomly selected from the universal public health insurance database and completed up to five mailed surveys (1996-2009). Participants reported on their infertility and use of treatment at age 28-33 years (survey 4 (S4) in 2006) and 31-36 years (survey 5 (S5) in 2009). The odds of resolved infertility at S5 were estimated using logistic regression with adjustment for age, area of residence, private health insurance and male infertility. Among 7280 women who responded to both S4 and S5, 18.6% (n=1378) reported infertility. More than half (n=804, 56.8%) of these women did not use treatment and 43.9% (n=347) gave birth between S4 and S5. Compared to infertile women who did not use treatment, women who used treatment were more likely at S5 to have recently given birth (odds ratio (OR) = 1.59, 95% CI 1.26-2.00) or be pregnant (OR = 1.77, 1.27-2.46). Further, women who used treatment were more likely to have twins (3.37, 1.18-9.62), premature births (1.52, 0.95-2.43), or low birthweight babies (1.83, 0.70-2.53) compared to women who gave birth without using treatment. Many women aged up to 36 years with a history of infertility can conceive naturally over a three year period without the use of treatment.Women who have never had a prior birth may need to use treatment to resolve their infertility but they are at higher risk of poorer perinatal outcomes, such as premature or low birthweight babies.

Vaccination to protect against infection of the female reproductive tract

Infection of the female genital tract can result in serious morbidities and mortalities from reproductive disability, pelvic inflammatory disease and cancer, to impacts on the fetus, such as infant blindness. While therapeutic agents are available, frequent testing and treatment is required to prevent the occurrence of the severe disease sequelae. Hence, sexually transmitted infections remain a major public health burden with ongoing social and economic barriers to prevention and treatment. Unfortunately, while there are two success stories in the development of vaccines to protect against HPV infection of the female reproductive tract, many serious infectious agents impacting on the female reproductive tract still have no vaccines available. Vaccination to prevent infection of the female reproductive tract is an inherently difficult target, with many impacting factors, such as appropriate vaccination strategies/mechanisms to induce a suitable protective response locally in the genital tract, variation in the local immune responses due to the hormonal cycle, selection of vaccine antigen(s) that confers effective protection against multiple variants of a single pathogen (e.g., the different serovars of Chlamydia trachomatis) and timing of the vaccine administration prior to infection exposure. Despite these difficulties, there are numerous ongoing efforts to develop effective vaccines against these infectious agents and it is likely that this important human health field will see further major developments in the next 5 years.

Rolling in the aisles : a comparative study of male and female grocery shopper typologies

The purpose of this paper is to segment male and female grocery shoppers based on store and product attribute evaluations. A rich profile for each segment is developed. Gender comparisons are operationalised and these developed contemporary shopper typologies are further contrasted against earlier works. Data of 560 grocery shoppers was attained by a survey questionnaire. Factor analysis, cluster analysis and ANOVA were employed to develop specific segments of shoppers. Four distinct cohorts of male shoppers and three cohorts of female shoppers emerge from the data of eight constructs, measured by 46 items. One new shopper type, not found in earlier typology literature, emerged from this research. This shopper presented as a young, well educated, at the commencement of their career and family lifecycle, attracted by a strong value offer and willingness to share the family food shopping responsibilities. This research makes a contribution to segmentation literature and grocery retail practice in several ways. It presents the first retail typology of male supermarket shoppers, employing a cluster analysis technique. Comparisons between male and female grocery shopping typologies are accordingly facilitated. The research provides insights into the modern family food shopping behaviour of men; a channel in which men are now recognised as equal contributors. Research outcomes encourage supermarket retailers to implement targeted marketing and rationalized operational strategies that deliver on attributes of importance. Finally, this research provides the basis for further cross-cultural, cross-contextual comparative studies.

Legal, cultural and practical developments in responding to female genital mutilation : can an absolute human right emerge?

Female genital mutilation (FGM) is a cultural practice involving the deliberate, non-therapeutic physical modification of young girls’ genitalia. FGM can take several forms, ranging from smaller incisions, to removal of the clitoris and labia, and narrowing or even closing of the vagina. FGM predates and has no basis in the Koran, or any other religious text. Rather, it is a cultural tradition, particularly common in Islamic societies in regions of Africa, motivated by a patriarchal society’s desire to control female bodies and lives. The primary reason for this desire for control is to ensure virginity at marriage, thereby preserving family honour, within a patriarchal social structure where females’ value as persons is intrinsically connected to, and limited to, their worth as virgin brides. Recent efforts at legal prohibition and practical eradication in a growing number of African nations mark a significant turning point in how societies treat females. This shift in cultural power has been catalysed by a concern for female health, but it has also been motivated by an impulse to promote the human rights of girls and women. Although FGM remains widely practiced and there is much progress yet to be made before its eradication, the rights-based approach which has grown in strength embodies a marked shift in cultural power which reflects progress in women’s and children’s rights in the Western world, but which is now being applied in a different cultural context. This chapter reviews the nature of FGM, its prevalence, and health consequences. It discusses recent legal, cultural and practical developments, especially in African nations. Finally, this chapter raises the possibility that an absolute human right against FGM may emerge.

Catapulting into STEM education : female students’ interactions within a middle school engineering project

Despite efforts to motivate students to engage in Science, technology, engineering and mathematics (STEM) education, women are still underrepresented in these areas in the workforce and higher education. Targeting females at high school or earlier may be a key towards engaging them in STEM. In this paper we report on the research question: How do middle school females interact for learning about engineering education? This ethnographic study, part of a three-year longitudinal research project, investigated Year 8 female students’ learning about engineering concepts associated with designing, constructing, testing, and evaluating a catapult. Through a series of lead-up lessons and the four lesson catapult challenge (total of 18 x 45-minute lessons over 9 weeks), data from two girls within a focus group showed that the students needed to: (1) receive clarification on engineering terms to facilitate more fluent discourse, (2) question and debate conceptual understandings without peers being judgemental, and (3) have multiple opportunities for engaging with materials towards designing, constructing and explaining key concepts learnt. Implications for teachers undertaking STEM education are evident, including outlining expectations for clarifying STEM terms, outlining to students about interacting non-judgementally, and providing multiple opportunities for interacting within engineering education.

Power of engineering : changing the perceptions of year 9 and 10 female school students towards an engineering career

BACKGROUND The engineering profession in Australia has failed to attract young women for the last decade or so despite all the effort that have gone into promoting engineering as a preferred career choice for girls. It is a missed opportunity for the profession to flourish as a heterogeneous team. Many traditional initiatives and programs have failed to make much impact or at best incremental improvement into attracting and retaining more women in the profession. The reasons why girls and young women in most parts of the world show little interest in engineering haven't changed, despite all the efforts to address them, the issue proposed here in this paper is with the perceptions of engineering in the community and the confidence to pursue it. This gender imbalance is detrimental for the engineering profession, and hence an action-based intervention strategy was devised by the Women in Engineering Qld Chapter of Engineers Australia in 2012 to change the perceptions of school girls by redesigning the engagement strategy and key messages. As a result, the “Power of Engineering Inc” (PoE) was established as a not-for-profit organisation, and is a collaborative effort between government, schools, universities, and industry. This paper examines a case study in changing the perceptions of year 9 and 10 school girls towards an engineering career. PURPOSE To evaluate and determine the effectiveness of an intervention in changing the perceptions of year 9 and 10 school girls about engineering career options, but specifically, “What were their perceptions of engineering before today and have those perceptions changed?” DESIGN/METHOD The inaugural Power of Engineering (PoE) event was held on International Women’s Day, Thursday 8 March 2012 and was attended by 131 high school female students (year 9 and 10) and their teachers. The key message of the day was “engineering gives you the power to change the world”. A questionnaire was conducted with the participating high school female students, collecting both quantitative and qualitative data. The survey instrument has not been validated. RESULTS The key to the success of the event was as a result of collaboration between all participants involved and the connection created between government, schools, universities and industry. Of the returned surveys (109 of 131), 91% of girls would now consider a career in engineering and 57% who had not considered engineering before the day would now consider a career in engineering. Data collected found significant numbers of negative and varying perceptions about engineering careers prior to the intervention. CONCLUSIONS The evidence in this research suggests that the intervention assisted in changing the perceptions of year 9 and 10 female school students towards engineering as a career option. Whether this intervention translates into actual career selection and study enrolment is to be determined. In saying this, the evidence suggests that there is a critical and urgent need for earlier interventions prior to students selecting their subjects for year 11 and 12. This intervention could also play its part in increasing the overall pool of students engaged in STEM education.

Reproductive health: findings from the Australian Longitudinal Study on Women’s Health. Chapter 5: fertility and infertility

Chapter 5: Fertility and infertility. p52-70. This section describes patterns of fertility across Surveys 1 to 4 among the cohort of women who were born in 1973-1978. This section includes the examination of pregnancy outcomes including both live births and pregnancy losses (stillbirths, miscarriages, terminations and ectopic pregnancies). This section also examines the prevalence of self-reported problems with fertility and whether these women sought advice and/or treatment. As women age they are more likely to experience infertility and, with little other data available, the ALSWH provides an important opportunity to examine this problem and the related use of health services. 1. Pregnancy losses are common. Half of the women who report a pregnancy outcome at Survey 4 have experienced a pregnancy loss. 2. More than one third (39%) of women who have experienced a live birth by Survey 4 have also experienced a pregnancy loss. 3. For every ten women aged 28-33 years in 2006: four women had not had been pregnant, five women had a live birth (with or without a recognised pregnancy loss), and one woman had a recognised pregnancy loss only. 4. Among women who had tried to conceive or had been pregnant, one-in-six had experienced infertility. (i.e. tried unsuccessfully to get pregnant for 12 months or more) 5. The most significant factors associated with having infertility, seeking advice and using treatment were: polycystic ovary syndrome, endometriosis and miscarriage. 6. Of the women who reported infertility, two-thirds sought advice but only half used treatment. 7. Most of the women who used fertility treatment had used low cost and non-invasive methods.

Social moralities and discursive constructions of female sex offenders

This article explores legal, scholarly and social responses to women identified as sex offenders. While much has been written on the male paedophile, rapist and sex offender, little research has been done on the role of gender and sexuality in sex offending. This article examines the ways in which the female sex offender is currently theorized and the discourses surrounding policy, legislative and media responses to their crimes. We identify contradictory public discourses where perceptions of female child abusers in particular often succumb to moral panic, in spite of many such offenders being given lenient sentences for their crimes. An examination of the discursive construction of female child abusers suggests that these contradictions are informed by underlying assumptions concerning harm and subjectivity in sex crimes. In exploring these contradictions we illustrate the ways in which such discourses are impacted by social moralities, and how social moralities construct offender and victim subjectivities differently, based on differences in gender, age and sexuality.

The relationship between anti-mullerian hormone in women receiving fertility assessments and age at menopause in subfertile women : evidence from large population studies

Context: Anti-Müllerian hormone (AMH) concentration reflects ovarian aging and is argued to be a useful predictor of age at menopause (AMP). It is hypothesized that AMH falling below a critical threshold corresponds to follicle depletion, which results in menopause. With this threshold, theoretical predictions of AMP can be made. Comparisons of such predictions with observed AMP from population studies support the role for AMH as a forecaster of menopause. Objective: The objective of the study was to investigate whether previous relationships between AMH and AMP are valid using a much larger data set. Setting: AMH was measured in 27 563 women attending fertility clinics. Study Design: From these data a model of age-related AMH change was constructed using a robust regression analysis. Data on AMP from subfertile women were obtained from the population-based Prospect-European Prospective Investigation into Cancer and Nutrition (Prospect- EPIC) cohort (n � 2249). By constructing a probability distribution of age at which AMH falls below a critical threshold and fitting this to Prospect-EPIC menopausal age data using maximum likelihood, such a threshold was estimated. Main Outcome: The main outcome was conformity between observed and predicted AMP. Results: To get a distribution of AMH-predicted AMP that fit the Prospect-EPIC data, we found the critical AMH threshold should vary among women in such a way that women with low age-specific AMH would have lower thresholds, whereas women with high age-specific AMH would have higher thresholds (mean 0.075 ng/mL; interquartile range 0.038–0.15 ng/mL). Such a varying AMH threshold for menopause is a novel and biologically plausible finding. AMH became undetectable (�0.2 ng/mL) approximately 5 years before the occurrence of menopause, in line with a previous report. Conclusions: The conformity of the observed and predicted distributions of AMP supports the hypothesis that declining population averages of AMH are associated with menopause, making AMH an excellent candidate biomarker for AMP prediction. Further research will help establish the accuracy of AMH levels to predict AMP within individuals.

Sample selection in a model of female labour supply : an alternative approach

Suggests an alternative and computationally simpler approach of non-random sampling of labour economics and represents an observed outcome of an individual female′s choice of whether or not to participate in the labour market. Concludes that there is an alternative to the Heckman two-step estimator.

Imputation of female labour market experience : some Australian evidence on the Zabalza and Arrufat method

Recent empirical studies of gender discrimination point to the importance of accurately controlling for accumulated labour market experience. Unfortunately in Australia, most data sets do not include information on actual experience. The current paper using data from the National Social Science Survey 1984, examines the efficacy of imputing female labour market experience via the Zabalza and Arrufat (1985) method. The results suggest that the method provides a more accurate measure of experience than that provided by the traditional Mincer proxy. However, the imputation method is sensitive to the choice of identification restrictions. We suggest a novel alternative to a choice between arbitrary restrictions.

Challenging the female underperformance hypothesis

Purpose – The question of whether female-owned firms underperform male-owned firms has triggered much research and discussion. Klapper and Parker's review concluded that the majority of prior research suggests that female-owned firms underperform relative to male-owned firms. However, using performance measures that control for size and risk (and after controlling for demographic differences such as industry, experience and hours worked) Robb and Watson found no gender performance difference in their sample of newly established US firms. The aim of this study, therefore, is to replicate Robb and Watson's study to determine whether their findings can be generalized to another geographical location, Australia. Design/methodology/approach – The authors test the female underperformance hypothesis using data from the CAUSEE project, a panel study which follows young firms over four years. They use three outcome variables: survival rates, return on assets and the Sharpe ratio. Findings – Consistent with Robb and Watson the results indicate that female-owned firms do not underperform male-owned firms. Originality/value – While replication studies are rare in entrepreneurship, they are an important tool for accumulating generalizable knowledge. The results suggest that while female-owned firms differ from male-owned firms in terms of many control variables (such as industry, owners' previous experience and hours worked) they are no less successful. This outcome should help dispel the female underperformance myth; which if left unchallenged could result in inappropriate policy decisions and, more importantly, could discourage women from establishing new ventures.

Retaining female postgraduates in academia : the role of gender and prospective parenthood

Women remain under-represented in almost all academic levels at universities internationally, and previous evidence has suggested that women move out of the university system in increasing numbers as they progress from postgraduate study to an academic career. The current study aimed to explore the role of gender in the reports of study experiences and future career plans of Australian postgraduate research students (n = 249). Questionnaire data indicated women were significantly less likely than men to rate an academic career as appealing. In particular, female postgraduate students without dependent children were least likely to want to pursue an academic career. On the basis of qualitative analysis, we attribute this finding, at least in part, to a perceived incompatibility between motherhood and an academic career and discuss the implications for gender equity in higher education.